Remote Medicare Claims Reviewer & Coder

J29; Gambrills (MD); Sur place; USD 55 000 - 85 000; Plein temps

Résumé du poste

J29 is seeking a Medical Reviewer, Coder for a temporary seasonal role in Maryland. The position supports automated and complex reviews of Medicare FFS claims to assess payment accuracy and compliance with CMS rules.

The role requires 5+ years of medical coding/billing, 3+ years in a productivity-based environment, and remote-work capability across systems. Certification by AAPC/AHIMA is preferred.

Qualifications

• 5+ years of direct medical coding or medical billing experience in a healthcare environment.
• 3+ years in a productivity-based claims or case-working environment using a queued case management system.
• 3+ years working remotely with various technology systems.
• Ideally 3+ years of Medicare FFS experience in a medical coding role or program.

Responsabilités

• Review Medicare FFS claims (Part A/B, DMEPOS, Home Health/Hospice) for overpayments, underpayments, and proper payments.
• Apply CMS rules and guidelines, ensuring claims are evaluated according to National and Local Coverage Determinations.
• Document clear, accurate findings for each claim; participate in dispute resolution with supporting documentation.
• Support QA through audits, training, and compliance with CMS security and privacy standards.

Connaissances

Direct medical coding

Medical billing

Remote work experience

Medicare FFS experience

Formation

AAPC/AHIMA certification (official)

Outils

Case management systems (low-code/no-code)

Description du poste

J29 is seeking a Medical Reviewer, Coder for a temporary seasonal role in Maryland. The position supports automated and complex reviews of Medicare FFS claims to assess payment accuracy and compliance with CMS rules.

The role requires 5+ years of medical coding/billing, 3+ years in a productivity-based environment, and remote-work capability across systems. Certification by AAPC/AHIMA is preferred.